There are many types of breast cancer, and it can be hard to keep them all straight. But metastatic cancer is different in that it’s not a type of breast cancer but rather a description of what the cancer is doing — in this case, spreading or metastasizing in areas of the body other than the breast. Metastatic breast cancer is the most advanced stage of breast cancer and may be called stage 4 breast cancer, distant breast cancer, or MBC. While metastatic breast cancer can invade many areas in the body, it most commonly spreads to the chest wall, bones, liver, lungs, and brain.
For patients with metastatic breast cancer, there is hope for a longer lifespan. In fact, more hope than ever before! Recent advancements in treatments specifically for advanced breast cancer allow patients to live a longer, fuller life.
What Causes Metastatic Breast Cancer?
Breast cancer can metastasize for a number of reasons. Often, it’s because of cancer cells that weren’t destroyed during the first round of breast cancer treatment. This could mean there were cells that couldn’t be detected in the breast, lymph nodes, or other areas of the body.
These surviving cancer cells can go dormant or hide, making them undetectable until they one day begin to grow and spread again. When they do, they can develop tumors in other parts of the body, starting with nearby lymph nodes or blood vessels. Even after the cancer has spread, it is still referred to and treated as breast cancer because it is made up of breast cancer cells.
Patients whose breast cancer has already spread at the initial diagnosis have “de novo” metastatic breast cancer.
Metastatic breast cancer is treated as breast cancer, even if it’s in an area of the body, such as the lungs or brain. The oncologist will determine which treatments may be most effective based on what you previously received and which treatments are now available based on specific genetic mutations that may be present in the breast cancer cells.
Metastatic Breast Cancer Symptoms to Watch For
The symptoms associated with metastatic breast cancer typically depend on where the cancer has spread and how much it has grown. If you are experiencing any of the below symptoms, bring them to the attention of your breast cancer doctor so they can treat them accordingly.
General symptoms to take note of include weight loss, vomiting, and fatigue. Other, more specific symptoms are related to the areas where the cancer has spread.
- Bone metastasis may cause pain in the bones, back, neck, or joints, bone fractures, or swelling.
- Brain metastasis could produce headaches, nausea, seizures, dizziness, confusion, changes in vision, changes in personality, or loss of balance.
- Lung metastasis can result in symptoms such as shortness of breath, difficulty breathing, or a constant dry cough.
- Liver metastasis might cause symptoms including yellowing of the skin or whites of the eyes, itchy skin, pain or swelling in the stomach, loss of appetite, or nausea.
Sometimes, your doctor may notice abnormalities after certain tests have been performed, such as high enzymes on a liver test or signs of a problem on a chest x-ray. If this happens, more testing will likely be needed for them to make an official diagnosis.
Any follow-up visits with your oncology team will include blood work that looks for “tumor markers.” If the numbers are rising, it’s a sign that cancer is growing again somewhere in the body. To identify where it’s growing, additional tests will be done.
PET-CT scans are also used as part of the follow-up care after treatment to watch for possible metastasis. This technology can often identify areas where cancer may be developing before it can be seen with the naked eye.
Discussing any symptoms you’re experiencing with your breast cancer specialist as soon as possible will also help narrow down where they should look first.
Questions to Ask Your Oncologist After a Metastatic Breast Cancer Diagnosis
The more you know about your metastatic breast cancer diagnosis, the more in control you will feel. Your cancer care team is there to help, so don’t be afraid to speak up with any questions or concerns you may have. Understanding your specific diagnosis and what to expect regarding treatment goes a long way in being able to make informed decisions about your care. It’s likely you’ve gained some useful knowledge from your first round of treatment that can help right now in deciding what steps to take next.
Here are some questions you might want to ask your oncologist as you consider your options:
- Based on the location of my cancer, what kind of prognosis can I expect? Is there anything I can do to improve it?
- What tests will I need before you can create a treatment plan?
- Will additional surgery be necessary?
- What are the goals of the recommended treatment(s)?
- Can you tell me about the risks and side effects associated with my treatment?
- Am I a good candidate for a clinical trial?
- How do you know if the treatment is working? What happens if it doesn’t?
- Should I consider getting a second opinion?
- Will I need to depend much on family or caregivers?
- How soon do I need to make a decision about treatment?
Keeping a notebook is a good way to stay on top of all the information you’ll receive during each of your appointments. You can also use it to jot down your questions. It also helps to bring a friend or family member along for support.
Available Treatment Options for Metastatic Breast Cancer
Patients with metastatic breast cancer have several treatments available to choose from. Most are considered systemic therapies because they treat cancer throughout the entire body. Several of these therapies are recently approved specifically for stage 4 breast cancer patients whose cancer has returned.
Your case will be evaluated closely by the oncologist when developing your treatment plan. The goal is to tailor it to your individual needs in a way that provides the best overall outcome.
Treatment Options for Metastatic Breast Cancer May Include:
- Chemotherapy to damage metastasized breast cancer cells as much as possible.
- Hormone therapy to shrink or slow cancer cell growth in hormone receptor-positive metastatic breast cancer.
- Targeted therapies to “target” specific characteristics of cancer cells to stop growth in metastatic breast cancer that may also be hormone-positive, HER2-positive, or triple-negative.
- Immunotherapy with a checkpoint inhibitor helps the immune system recognize and attack cancer cells. This is an emerging treatment for breast cancer.
Surgery to remove breast cancer and radiation therapy aren’t typical approaches for treating metastatic breast cancer. Cancers that have spread to areas such as the bones might not be possible to remove surgically. Radiation therapy for breast cancer is typically used for a localized treatment area, therefore, making it useful in only treating distant tumors that are causing discomfort.
Before beginning treatment, it’s important to take the time to discuss what to expect from each type of recommended treatment with your breast cancer specialist. Remember that your cancer care team is there to help you make good decisions about your treatment, so be sure to speak up so you can understand as much as possible.
Self-Care While Living with Metastatic Breast Cancer
While the kind of cancer treatments you receive is an important part of living with metastatic cancer, it’s just as important that you maintain proper self-care, ensuring that your other needs — both physical and emotional — are met. Talk with your cancer care team about any resources you could benefit from, such as information on nutrition and exercise, stress management, support groups, approved complementary therapies that can help improve your quality of life, and more.
Read our related blog called Exercise and Breast Cancer: The Benefits and How to Get Started.
Metastatic Breast Cancer Care For Those in the Portland-Vancouver Area
It is possible to live with metastatic breast cancer, and the oncologists at Compass Oncology are here to help you do so. We offer comprehensive, compassionate, and patient-centered cancer care that also includes access to clinical trials. Learn more regarding What You Should Know About Breast Cancer Clinical Trials.
The breast cancer oncologists at Compass Oncology create personalized breast cancer treatment plans for patients using the latest treatments. This is available even if you received your initial breast cancer treatment elsewhere. Contact us today at one of our cancer centers located in the Portland, Oregon, and Vancouver, Washington, areas.
